The-Shift-Shapers-Podcast-(Rough-Comp-2)

Deconstructing health plans is a challenge – especially so in small markets. What are those conversations like, and is it possible to achieve success with new health plan strategies outside of large markets? Josh Baker, President of Butler Benefits in Amarillo, Texas, shares his experience and success secrets with us.

What You’ll Learn From this Episode:

  • How did he end up opening an agency with his wife?
  • What are some of the small marketplace challenges?
  • Special hurdles to overcome in a state with an average 18% renewal last year.
  • What a DPC model looks like when applied to pharmacy.
  • Why much of the change is fundamental.

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The-Shift-Shapers-Podcast-(Rough-Comp-2)

Mike Dendy is CEO and Founder at Advanced Medical Pricing Solutions (AMPS) and a student of the irrational pricing and misaligned incentives that drive today’s US healthcare system. We begin our conversation by discussing the widely-held myth of the PPO discount. From there we explore the general pricing methodologies and incentives in healthcare.

Once you wrap your head around all of that, the discussion of how often claims are incorrectly priced and what can be done about it will bring us to a conversation around a concept known as “Direct Contracting”. We will also find out why Mike thinks that healthcare is like the OPEC oil cartel.

What You’ll Learn From this Episode:

  • What is the myth of the network discount?
  • Why does that matter to patients and payers alike?
  • Will networks be eliminated or replaced with personal networks?
  • How accurate are most claims?
  • What is “direct contracting” and what problems can it solve?

Featured on the Show:

Listen to the Full Interview:

This Episode is Sponsored by:

Enjoy The Show?

Subscribe-with-iTunes-smallSubscribe-with-Stitcher-smalliHeartRadio-small